Donhuijsen K, Hattenberger S, Schroeder H G
Institut für Pathologie, Klinikum Braunschweig.
Pathologe. 2004 Feb;25(1):14-20. doi: 10.1007/s00292-003-0668-z.
Sinonasal carcinomas are usually of the squamous cell or transitional cell type. Adenocarcinomas of the inner nose and the paranasal sinus correlate with exposure to wood dust. However, this is only true for adenocarcinomas of the intestinal type and not for salivary gland carcinomas or polymorphous low-grade adenocarcinomas. Of 160 cases with a history of wood dust exposure and malignant tumors of the inner nose, 134 were sinonasal adenocarcinomas of the intestinal type (SNAIT). In addition, there were 24 other carcinomas as well as 1 malignant melanoma and 1 malignant synovial tumor. The SNAIT showed various subtypes with great morphological similarities to colorectal adenocarcinomas (papillary tubular cylinder cell: 72.4%; alveolar goblet cell: 5.2%; signet ring cell: 3.7%; transitional type: 18.7%). Highly differentiated adenocarcinomas (G1) and mucinous adenocarcinomas were relatively frequent: they accounted for 23.1% and 29.1% of the 134 SNAIT, respectively. Apart from wood dust, wood additives are discussed as a carcinogenic factor. With the development of SNAIT, a metaplasia-dysplasia-carcinoma in situ sequence is probable. If the clinical course shows few symptoms, the first manifestation of such a tumor often occurs in an advanced stage.
鼻窦癌通常为鳞状细胞或移行细胞类型。鼻内和鼻窦的腺癌与接触木尘有关。然而，这仅适用于肠型腺癌，不适用于涎腺癌或多形性低度腺癌。在160例有木尘接触史且患有鼻内恶性肿瘤的病例中，134例为肠型鼻窦腺癌（SNAIT）。此外，还有24例其他类型的癌以及1例恶性黑色素瘤和1例恶性滑膜瘤。SNAIT表现出多种亚型，在形态上与结直肠腺癌有很大相似性（乳头管状柱状细胞型：72.4%；肺泡杯状细胞型：5.2%；印戒细胞型：3.7%；移行型：18.7%）。高分化腺癌（G1）和黏液腺癌相对常见：它们分别占134例SNAIT的23.1%和29.1%。除木尘外，木添加剂也被认为是一种致癌因素。随着SNAIT的发展，可能会出现化生-发育异常-原位癌序列。如果临床过程症状较少，这种肿瘤的首次表现往往出现在晚期。
